HomeMy WebLinkAboutMortgage_Malone (2) a. STATEMENT OF MORTGAGE OR CONTRACT INDEBTEDNESS County 1'�bv�ist/
ter,;; FOR DEDUCTION FROM ASSESSED VALUATION
l State Farm 43709(R71/6-09)
i", Prescribed by Department of Local Government Finance
Filerlter$ 1
INSTRUCTIONS: JCI' r I
To be filed in person or by mail with the County Auditor or County Recorder of the county where the property is located. Form Ned with:
Filing Dates: 1) Real Properly:Must file during the year for which the deduction is sought - Coun p ' .
2)Mobile/Manufactured Homes not ac.c sled as Real Property Must file during the twelve(12)months - i ':
before March 31 of each year the deduction is sought. - G :St� Cy' V�.t. .A U D •
See reve • :.'se for additional instructions and qualifications.
Al. ,., o : ormr/treU ;Kr�
- 4o - 060. / 26- Da72 number 1/3 7t-7
Assessed value of real property as of ��//�' Mortgage/Contract indebtedness unpaid as of Mortgage/Contract indebtedness unpaid as of Is the applicant the sole
March 1,current year March 1,current year date of application / legal or equitable owner?
,L/,�ri ❑ Yes ❑ No
If no,what is his/her exact share of interest? If owned with someone other than spouse,indicate with whom
If name on record is dfIerent than that of applicant.indicate below: a property in question:Annually Assessed
Real Property ❑Annually Assessed
Mobile Home(IC 6-1.1-7).1-7)
Name of mortgagee or contract setter / Mobile/ ` 2—i
Address of mortgagee or contract seller(number and steel,city,state,a�...e)
Name of assignee or other owner or holder of mortgage
Address of assignee(number and street,city,state,and ZIP code)
Does applicant own property in any other If yes,what county? - What Taxing District? Has this deduction been requested on property
minty in Indiana? current Yes ❑ No for rrent yea? ❑ Yes ❑ No
COUNTY AUDITOR
Deduction approved in the amount of:
20 20 20 20 2P-. — __ _.. ..... �i////�1\) i
Signature of Cowry Auditor County D r a\�e r NO O `Ir' '.-U I.-/ —
I/We certify under the penalty of perjury that the above and foregoing information is true and C/� I
\ owner/contract buyer of the aforementioned property on date application is filed. Card NO. J7Jv r
—
Signa.re(ownersI ,name)
M" a A t .a.. _ _ "LA, Ati, /,
+ F 0 —":•ern address of applicant(nergker and street.city, .te,and ZIP
IY7d N Old (41f,s tt ft Yr1Y1(ef(by, ).,, (4.-nu 10
Person authorized by duty executed Power of Attorney o9by IC 6-1.1-12-0.7 Date(month,day,year)
Address of authorized person (number and street,dry state.and ZIP code) .